NPIMap

Individual provider Active NPI

Hagop P Ghazarian, DPM

  • Podiatrist
  • Mattawan, MI
National Provider Identifier
1609820331
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001642 Issued in MI
Practice address
8748 Pine Island CT S
Mattawan, MI 49071-9555
Phone
(269) 353-7277
Fax
(269) 353-7277
NPI assigned
May 19, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001642 MI Primary

Addresses

Primary practice location

8748 Pine Island CT S
Mattawan, MI 49071-9555

Mailing address

8748 Pine Island CT S
Mattawan, MI 49071-9555
Phone (269) 353-7277

Other identifiers 2

IdentifierTypeStateIssuer
4858000160OtherBCBS
3526895MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000083 MI Practitioner - Podiatry 0042105348 Practice locations: Kalamazoo, MI; Leslie, MI; Mattawan, MI; Muskegon, MI; Niles, MI; Paw Paw, MI; Plainwell, MI; Portage, MI…

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901001642MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Podiatry PC Podiatrist Past Accepting new patients
The Avenue Family Network, Inc. Past Accepting new patients
TLS Litchfield, LLC Past Accepting new patients
Crestwood Manor, LLC Past Accepting new patients
Cretsinger Care Homes, LTD. Past Accepting new patients
Best Way Providers, Inc. Past Accepting new patients
Family Living Afc, Inc. Past Accepting new patients
Freds Supermarket and Pharmacy of Three Rivers Inc Past Accepting new patients
Psychiatry Subspecialties Consultants PC Past Accepting new patients
Meadowview Garden Afc Past Accepting new patients
Old Farm Living Center Past Accepting new patients
Hudson's Country Manor, Inc Past Accepting new patients
Long Acres Afc Past Accepting new patients
Dennis & David Company Past Accepting new patients
Loving Care Foster Homes Past Accepting new patients
Jenny's Place Past Accepting new patients
Golden Years Personal Care Home Past Accepting new patients
Hudson Country Manor Inc. PastSince Jul 3, 2022 Accepting new patients
St. Joseph County Commission on Aging Past Accepting new patients
Cozy Hill a.F.C. L.L.C. Past Accepting new patients
Serenity Shore Assisted Living Facility, LLC Past Accepting new patients

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609820331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8748 PINE ISLAND CT S",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719555",
            "telephone_number": "269-353-7277",
            "fax_number": "269-353-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8748 PINE ISLAND CT S",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719555",
            "telephone_number": "269-353-7277",
            "fax_number": "269-353-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAZARIAN",
        "first_name": "HAGOP",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4858000160",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3526895",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattawan, MI

Sources for this page

Verify at the official NPI Registry.